MEDICARE: JAMIE LEIGH CLAYTON RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133N00000X	Nutritionist	86071348	WA
2	133V00000X	Registered Dietitian	DI60852792	WA
3	133V00000X	Registered Dietitian	86071348

General Provider Information

NPI Number	:	1265921548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE LEIGH CLAYTON RD

Provider Business Mailing Address
First Line	:	307 N OLYMPIC AVE STE 233
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-1322
Country	:	US
Telephone Number	:	425-243-3204
Fax Number	:	206-385-7380

Provider Business Practice Location Address
First Line	:	307 N OLYMPIC AVE STE 233
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-1322
Country	:	US
Telephone Number	:	425-243-3204
Fax Number	:	206-385-7380

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2018
Last Update Date	:	03/24/2026

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